The book of wisdom tells there is a time for everything under the sun. A time to be born a time to die. Sooner or later each person will have an appointment with death, and by extension, each family will have to endure the death of a loved one.

The circumstances of a person’s demise might be intense and swift as in a massive heart failure. On the other hand, it may be a slow grueling exit often occurring with pain, much discomfort, and stress.

Most of the persons in a long-term care facility are aged. The facility becomes their home, where they are cared for until death. Some residents accept this fact gracefully. However many struggles with this transition, and constantly express a longing desire to return home. This, despite great efforts by many care facilities to decorate their new homes with emotional artifacts and memoirs of families, friends, events, and adventures of their past life.

The more sophisticated facilities employ the services of the recreational therapist, physiotherapists, and occupational therapists to design creative, stimulating activities to engage the minds and interests of residents; to add value and some limited excitement during the wait.

However long the wait, a point will arrive when care-aids will be informed that a resident is palliative and will need to be provided comfort care.

What is comfort care?

Generally, comfort care is not only for the resident but also the visiting families. As stipulated by the care plan, the resident may need to be repositioned every hour. This in order to present pressure sores, as well as to relieve pain.

If breathing is stressful, then oxygen therapy is applied. Mouth care is very important during this period as mucous secretions build up in the mouth; may even require suction to clear the throat.

Often the residents have stopped eating solid food but may be able to take some fluids to moisten the mouth and throat. Pain relief medications may intensify. Ultimately the intention is to offer as much comfort and relief in the last moments of a dying resident.

The emotional separation is equally stressful for the caregivers. Issues of one’s own mortality come to the fore and question asked might be ‘how far am I on my appointment with death?

Have you tried reading a book in this heat? It’s virtually impossible to finish a paragraph. Brain fog is not a myth. The National Bureau of economic research found that test scores are lower when temperatures are high, but only in schools without air conditioning.

Studies have also shown that people seem to have a harder time making decisions in the heat. Convenience stores sell fewer lottery tickets from their wide array of scratch-offs, while still selling plenty of the pick-six type.

Similarly, when the temperature was hot, more people chose cell phone plans that looked like a good deal on the surface but would cost more in the long run. At cooler temperatures, people were more willing to do the math to choose the better option.

So, what can we take from the above? Heat does affect our ability to make cognitively complex decisions. So if you need to do some reading or hard thinking this summer, schedule your most demanding tasks for the morning or evening when it’s cooler, or consider plugging the A/C.

Dementia is a progressively degenerative disease of the brain that inflicts the more senior persons in our community. Though there are several cases where persons of unexpected younger age are admitted for having what is described as ‘early onset’ of the disease.

Depending on the specific section of the brain that is affected the disease manifest itself in many complex ways that impair the person’s cognitive competencies, mood, physical mobility, perceptions, memory, speech, and recognition. Although in recent years much research work is done, still little is known about the nature of this disease.

“Once a man, twice a child”, that proverbial saying often comes to mind when providing activities of daily living (ADL) to a resident. Often this entails brushing the teeth, changing clothes, giving a bath, and combing the hair.

Among many dementia sufferers, there is the progressive loss of balance and ability to move independently. So the use of specialized wheelchairs and walkers is essential. Locomotion from bed to wheelchair and vice versa entails using specialized weight bearing or non-weight bearing lifts.

All the above activities take place within the schedule of timetables for breakfast, lunch, supper and snack times. The times may differ based on the institution. But generally, breakfast starts at 9-10:30. Lunch 12 – 1:30 and supper at 6 – 7:30 and before bed snack.

Resident care is specific to the particular needs of the individual. The care plan is the document that all caregivers reference as a guide to the peculiarity of the resident. It prescribes how, when, why of the care given. The healthcare provider must, therefore, be very familiar with the care plan for each resident. This, of course, gets easier with continued care of the resident.

Similar to all professional service provider client privacy and confidentiality is of utmost importance.

I got a copy of this book for Mother’s day from my daughter.’ One Hundred years of solitude’ written by Nobel prize winner for literature Gabriel Marquez, is definitely one of the most interesting, and wildly engaging books I have ever read.

It is both fiction and truth as Marquez weaves history with fantasy as he relates the rise and fall, birth and death of the mythical town of Macondo through the history of the Buendia family. Marques is a true storyteller. Events move quickly and seamlessly between what is magical and real, what is pure and honest humanity.

I would recommend anyone wanting to read a timeless, true masterpiece of literature to own a copy of this great literature and read it over and over. This is my second read and I intend to relish every page as I did the first.

It is very rare that success is an accident. More likely success comes from being in the right place, at the right time, and taking the right action. Essentially it takes time and process.

Time is the measuring of periods between one event and another or between actions and its perceived consequences. Usually, we associate time with the clock and calendar. In life-planning, time includes the period between now and the most distant future event you can imagine as well as whatever increments between those endpoints you determine are useful in the manifesting of your goals.

A process is your observation of, and interchange with others or yourself. There are two types of process: individual and group. Sometimes the individual and group may converge on certain issues and diverge on others.

As an individual, you ‘process’ your thoughts, feelings and attitudes. You observe them internally in the constant dialogue that goes through your mind. As a member of a group, you may ‘process’ common interests, attitudes, and observances. You will either agree or disagree with others, and they will either agree or disagree with you.

Time and process are frameworks for understanding your personal experience relative to others. It assists you in allocating your resources, paces your actions and ordering your priorities. Time and process facilitate your success.

You may find that your viewpoints about time and process often limit your experience and create boundaries that prevent you from being successful. Procrastination is a viewpoint about time with which you may be familiar.

Sabotage is a viewpoint about the process. It denotes a belief that you are best served by hampering or subverting the actions of yourself or others.

As we endeavour to establish timelines for our goals we are encouraged to be flexible. as the precise timing of life plans, are often mysterious. Just understanding this helps us to handle the feelings of disappointment and frustration when events do not meet your schedule.